Anatomy
The back is made up of box-shaped vertebrae that are held in place partly by the shape of the bones, partly by ligaments and partly by the large and small back and abdominal muscles.
Cause
Spinal misalignments (scoliosis) seen from behind can occur in two ways:
1) Functional spinal misalignment is often caused by unequal leg length and the misalignment is corrected by appropriate elevation under one leg and
2) Organic spinal misalignment often occurs for unknown reasons (idiopathic spinal misalignment), but hereditary factors are involved.
Idiopathic spinal misalignment usually develops gradually during childhood or early adulthood and is frequently seen in athletes (Mousavi L, et al. 2022). In some cases, back trauma and decalcification (osteoporosis) can lead to spinal misalignment.
Symptoms
Initially, spinal misalignment is usually painless and found randomly. Later on, pain may develop.
Examination
It is important to make the diagnosis as soon as possible, as the outcome will improve if treatment is started as soon as necessary.Attention should therefore be paid to early signs of spinal misalignment (uneven shoulder or hip height, prominence of one or both shoulder blades, skewed waist). In the case of idiopathic spinal misalignment in children, referral to a specialist orthopaedic surgeon should be made for examination and possible control. X-rays will show the severity of the spinal misalignment.
In children, leg shortening due to functional spinal misalignment can be compensated for during growth, which should be checked, for example, at one-year intervals.
Treatment
Functional spinal misalignment due to unequal leg length can be treated by raising the soles, as it is not usually corrected 100%.
The treatment for idiopathic spinal curvature is dependent on the severity. Mild cases do not require treatment. Ergonomic guidance is recommended for all. Continued moderate sports activity in teenagers reduces symptoms and progression. Muscle strengthening exercises, balance training and stretching of abdominal and back muscles are recommended (Seleviciene V, et al. 2022).
Regular 30-minute walks (3-5 times a week) reduces lower back pain and almost doubles the time interval for low back pain recurrence requiring treatment (Pocovi NC., et al. 2024).
If the spinal misalignment worsens and the young person continues to grow, support bandages can be used. If the spinal misalignment becomes pronounced, surgery may be considered.
Complications
In some cases, spinal misalignment may have other causes (infections, nerve disorders, congenital bone changes, arthritis, bone diseases, metabolic disorders), so all should be assessed by a specialist.
